The following article originally appeared in the Well Beings newsletter,
a publication of Vaccinations Alternatives, NYC,


Putting A Happy Face On Tyranny
By Gary Krasner

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As the undisputed master of public relations and political flimflam, the
Clinton Administration had led a mostly bipartisan coalition to pass the
most Draconian laws since the old Sedition Acts. It has been dressed up
for the public as consumer-friendly, happy-meal measures to deal with
children's health insurance, tax and welfare cheats, health Insurance
portability, patients' rights, illegal immigrants, and deadbeat parents.
But will Americans swallow it?

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Last year Congress voted on whether to authorize funds, and thereby
implement, several regulations proposed by the Clinton Administration
that will significantly reduce our ability to keep our medical affairs
private, make medical decisions for our children, travel or open a bank
account, or apply for a broad range of licenses or government services.
These regulations-authorized by legislation passed in the last few
years-had also paved the way for individual states to commence
computerized vaccination tracking programs. Such programs have already
improved the ability of many state health and welfare agencies to harass
and coerce parents to vaccinate their children. It's also going to
facilitate the establishment of a national vaccination database on all
children in the U.S.

Ironically, while the Administration characterizes the opponents of these
overreaching laws as "anti-government libertarians", "rigid
Constitutional extremists", and "gun nuts", these groups will not be the
most adversely affected by these laws. Instead, it will be average
conscientious parents wishing to make appropriate medical decisions for
their own children. In fact, look no further than the thirty or more
states that are aggressively enforcing child vaccination requirements
through their newly established, federally funded vaccination database
tracking systems. In these states, so called "unfit" parents are losing
custody of their own children to child protection agencies for having the
"audacity" to say, "That vaccine disabled my first child. I will not
allow it to be given to my other children."

How It Began
Initiating a national vaccination tracking infrastructure requires some
form of national ID system to be in place. Clinton and his associates
snuck in such a system by packaging it as health care reform. A National
ID Card first appeared innocuously concealed in the Health Security Act
of 1994 as a "healthcare benefits card" that Hillary Clinton insisted had
to be carried by every American-even if they refused to be covered by the
plan-under penalty of law. Jon Christian Ryter described how the Act
became law:

"The Clintons knew a National ID Card spelled problems, regardless what
name was put on it. However, as a healthcare card that provided each
American with thousands of dollars of free medical care, they correctly
surmised that the ramblings of the right wing zealots could be easily
dismissed by the mainstream liberal media. The media did its job well.
According to the media, the Health Security Act would provide healthcare
for the millions upon millions of uninsured Americans. The media even
obliged by ignoring the obviously flawed cost assessments as well.
Hillary demanded that Congress pass the Health Security Act without any
changes. But Congress rejected it as too expensive and experimental.

Buried in the National Archives, in the working papers of the Hillary
Clinton healthcare plan, was the game plan in the event the Health
Security Act went down in defeat. It was to implement another healthcare
act that provided healthcare for children. They thought, no one would
dare deny healthcare to children. Senators Ted Kennedy and Orrin Hatch
introduced the plan in Congress, and the Health Security Act passed in
1994."

Once it became law, the bureaucracy possessed the authority to simply
expand it to include anyone and everyone. But the legislation still
required funding to create a biometric health care card. The authority to
do it was there, but not the money. For the money, the Clinton
administration turned to the Robert Wood Johnson Foundation (RWJF). The
foundation, created by the founder of the Johnson & Johnson
pharmaceutical and health supply company, obliged and funded the
experimental program which was kicked off in three western cities. (Note:
The lawsuit by groups that were barred from the First Lady's health care
reform meetings revealed that Hillary Clinton-a past Program Director of
RWJF-and nearly 1000 of the 2000 people on Ira Magaziner's
Interdepartmental Working Group were either employees, officials, health
policy fellows, grantees, contractors or grantee institutions of RWJF.)
The card recorded the inoculation records of children, as well as
everything from DNA typing, to the individual's medical, psychiatric and
financial history. And unlike an ID in the form of a National Driver's
License (described later), this Health Passport Card for at least one of
the pilot cities (Denver) contained a tracking chip that could track the
movements of each Health Passport card holder.

How It Was Expanded
In addition to children's health, The Clinton Administration wanted to
establish a national ID number system to deal with "welfare reform",
"illegal immigration", "healthcare portability", and "gun control". They
ignored arguments that it was not essential to deal effectively with
these issues by placing our individual liberties at risk.

As we pointed out in our last issue ("Big Brother Is Watching"), there
must be a unique number for a government to efficiently track your
activities. To use Social Security numbers for this purpose, the 1974
Social Security Privacy Act and other protections were nullified (by
permitting the SSA to send SSNs of babies born since 12/31/90 to each
State's Bureau of Vital Statistics, without securing parental consent,
for the purpose of establishing and maintaining vaccination registries)
by legislation enacted between 1994 and 1996. In the guise of complying
with the GATT provisions and to locate "deadbeat dads", H.R.3453 was
passed in 1995. To deal with illegal immigration, H.R. 2202 was passed in
1996. In effect, this allowed the Transportation Department to mandate
that Social Security numbers (SSN) be included on state-issued driver's
licenses. Before that could proceed, Clinton first had to issue Executive
Order 13083, which many believe violated the Tenth Amendment to the
Constitution. Finally, in 1996 welfare reform added further to the
sharing and cross referencing of our SSNs, such as requiring them for all
kinds of professional, commercial and recreational state license
applications, and to require employers to report to the Feds all newly
hired employees.

Although using a centralized unique number system reduces the costs and
redundancy of many functions of government, there are great dangers as
well. Lack of safeguards invites a variety of abuses, such as theft of
data or unauthorized access by persons or corporations, or the spread of
inaccurate information. The damages from the latter are usually
irreversible, because computer data that is so widely dispersed is much
harder to correct or delete than it had been to create it. Also, more
Social Security fraud and rip-offs would occur because more people would
have access to the numbers with the cross-referencing data (the SSN is,
in effect, similar to a person's bank account number). Finally, as we'll
see with vaccination mandates, concerns about privacy pale in comparison
to the overwhelming power of the state to coerce or penalize dissenters
or non-participants. Dr. Richard Sobel, a research fellow at Harvard Law
School said, "The American political system was set up to be inefficient;
to divide power. What ID numbers do is centralize power, and in a time
when knowledge is power, then centralized information is centralized
power."

>From Law To Enforcement
Before any of these laws can actually affect us, implementation
mechanisms and guidelines must be proposed by the intended enforcement
agencies, and then Congress must decide whether to appropriate funds for
them. Much of that activity began last year. But groups as diverse as
civil libertarians and ultra conservatives had managed to delay some of
the laws from being implemented. Before we discuss vaccination tracking
specifically, here's an itemized list of the various implementation
proposals considered in the previous session of Congress, the dangers
they pose to our liberties, and their current status:

(EIN) Tracking Health Care through Employers. As part of the Health
Insurance Portability and Accountability Act of 1996 (HIPAA), the
Department of Health and Human Services (DHHS) had proposed rules to
identify patients through the tax identification number (TIN or SSN)
already assigned by the IRS. The National Standard Employer Identifier
(EIN) is intended to help eliminate paperwork, simplify activities such
as enrollment in health plans and payment of health insurance premiums,
and save money for consumers. Under the proposed rule, health care
providers, health care clearinghouses, and health plans would use this
number to identify the employer on electronic health transactions.
Currently, health plans, providers, and employers use different ID
numbers for an employer when they conduct business. Objections: Since
this rule would require employers to record employees' private health
transactions in a database, Congressman Ron Paul, M.D. (R-TX) pointed out
that, "this will allow coworkers, hackers, government agents and other
unscrupulous persons to access the health transactions of every employee
in a company simply by typing the company's identifier into their PC".

(NPI) National Provider Identifier, (also part of HIPAA, see above) will
track all those who provide health care services or equipment through one
or several linked registries. Since every electronic, and perhaps paper,
transaction will be required to use the NPI, tracking of patient data may
be possible. Using NPI, government can track the whereabouts, residence,
credentials, and practice of every health care professional in the
nation, from doctors to nursing assistants. Government can track not only
providers who treat government recipients (Medicare and Medicaid), but
all providers. No provider will be able to relocate w/o informing
government of his whereabouts. Objections: NPI is invasion of personal
and professional privacy, and a prohibition on freedom to practice.
Government determinations of medical necessity or cost controls may be
used to increase revenue from fines and penalties. Providers may fear
government reprisal regarding diagnosis and treatment decisions and treat
patients less aggressively than their professional judgment prescribes.
Since all health care transactions must use the NPI, the government may
be able to track individual patients through their providers without the
patient's consent. May push citizens into black market medicine
particularly for privacy reasons. Places government in the role to decide
what constitutes "acceptable" health care.

(NID) National ID. Social Security number (SSN) to be used on state
driver's licenses. As a result of the 1996 Illegal Immigration Reform and
Immigrant Responsibility Act of 1996, a federal agency may only accept as
proof of identity a driver's license or identification document that
contains a visible or electronically readable SSN, with one or more
security features (magnetic strip, bar code, hologram, etc.). In
addition, the SSN may become the unique patient identifier and allow
medical record linkages. Objections: If implemented, this will allow all
citizen transactions to be monitored, all data on citizens to be linked,
and identities to be stolen (it happened in Virginia until they took the
visible SSN off the card). As a de facto national ID card/internal
passport, it would enable the federal government (not the states) to
track, and potentially control everyone's movements throughout North
America. As such, it is contrary to the original intent and guarrentee
that SSNs would not be used for identification. (Rules were issued by the
National Highway Traffic Safety Administration.)

(UPI) Unique Patient Identifier. (also authorized from HIPAA above). The
purpose is to assign every American a "unique health identifier": a
number that could be used to create a national database that would track
every citizen's medical history from cradle to grave. Patient health
records could be moved as they switch from one insurance plan to the
next. Old records would be easier to retrieve. Billing would be
streamlined and more efficient. A national disease database could be
created, offering unlimited opportunities for scientific study.
Objections: No penalties for violations of privacy and confidentiality,
and is virtually unenforceable if there were. Abuse could be widespread,
and very damaging in that medical information is inherently more personal
by its nature. Currently, computers at one managed-care company cannot
communicate with those at another. But once different plans can talk to
one another via a single reference number, patient privacy will be
virtually nonexistent.

Current Status Of The Regulations
Essentially, EIN requires employers to use SSNs; NPI requires health
providers to use them; UPI requires you (and possibly others) to use
them; and NID will require state motor vehicle departments to use them.
Many arguments were made against these rules. Rep. Ron Paul, whose
amendment to place a one-year moratorium on financing these rules had
failed, said that they lacked constitutional authority: "Any federal
action that oversteps constitutional limitations violates liberty for it
ratifies the principle that the federal government, not the Constitution,
is the ultimate arbitrator of its own jurisdiction over the people."

By the end of the legislative session, Congress merely disallowed any
money that was appropriated in the general funding bill to be used for
issuing a final federal regulation to implement the NID (federal drivers
license). But other funds, even reserve or slush funds from other
legislation, could be used to do so. But given the fact that it was the
major government funding bill, it would be difficult. But there was no
language to prohibit it either. Another clause had suspended Clinton's
Executive Order 13083, which had, in effect, authorized the National
Highway Traffic Safety Administration to issue the NID rules. This year
there's still a fair chance for an outright repeal of the NID section of
the bill in the wake of the widespread public opposition that was
demonstrated last year, and after the American Association of Motor
Vehicle Administrators-an influential pseudo-private, quasi-government
organization-had withdrew its decade-long support for the use of SSNs on
driver's licenses, and recommended the repeal of the provision.

The group of health identifiers did not fare as well. The unique patient
ID (UPI) was not repealed, however it cannot be instituted unless it is
specifically re-enacted into law by new legislation. On the other hand,
Congress allowed the use of funds to enact the Provider ID system (NPI)-a
federally issued number and national tracking system on all health
practitioners, and the inclusion of the employer tax identification
number (EIN) on every medical bill, claim, treatment approval or denial,
and patient record that is electronically transacted.

On January 8th, 1999, Congressman Ron Paul introduced the Freedom and
Privacy Restoration Act of 1999. This amendment to the 1999 Labor, HHS
Appropriations Bill was supported by the American Assoc. of Physicians
and Surgeons, the ACLU, and others. Fortunately, the amendment had passed
and the funding for federal health agencies to create and assign UPIs was
removed for this year. This bar to funding UPI will have to be renewed
for next years' HHS Appropriations bill, and the year following that,
until we elect a president who understands the problem with this law.
Send a "thank you" letter to Congressman Paul: 202-225-5785 fax,
202-225-2831 phone, <rep.paul@mail.house.gov> email.

Finally, the often-mentioned "Patient's Bill of Rights" was the latest
among the Administration's talking points, and has bipartisan support for
many of the provisions that rely on the same mandated tracking of
patients (UPI, NPI, EIN) and the accompanying privacy and confidentiality
risks already discussed.

Vaccination Tracking
The most oppressive and pernicious use of a unique identifier involves
tracking the vaccination status of children. In the hands of state health
bureaucrats intent on carrying out a (spurious) mandate, the medical,
philosophical, or religious convictions and rights of people are
inevitably violated. As the most pro vaccination president since Jimmy
Carter, the incentives and mandates coming from Clinton's Administration
have never been greater than they are now. It requires an inexhaustible
supply of arrogance to claim to know better than you what is best for
your child. As the following events clearly show, Clinton and his
associates were up to the task.

During the 1993 public policy debate over the massive Health Care Plan
proposed by First Lady Hillary Clinton, a broad-based, non-partisan
coalition had defeated the implementation of a federally-funded
vaccination database that was a component of the Comprehensive Child
Immunization Act. This database would have established a tracking
mechanism for every child born in the United States. The coalition was
successful in having the database authorization removed from the
legislation. Six months later in September 1993, an amendment was
covertly attached to a bill that allowed for the creation of state and
local inoculation databases, in contrast to the federal database that
raised so much opposition. A $417 million federal price tag was initially
attached to pay for the implementation of the state databases, with
additional funds awarded as incentives to states, proportional to their
vaccination compliance rates. At the earmarked rate, these "incentives"
given to state health departments can amount to about $20 billion
nationally. What administration would rationally consider spending these
sums-and allow drug companies to reap enormous profits-just to increase
vaccination rates among pre 2 year-olds a mere 10%. Nevertheless, the
amendment was approved, and to date about two-thirds of the states in the
U.S. have fully functioning vaccination databases.

The creation of these state databases have been accomplished in no small
measure to several federal agency mandates and the passage of the mammoth
Health Insurance Portability and Accountability Act (HIPAA) in 1996. HHS
Secretary Donna Shalala signed an order that allowed the Social Security
Administration to release all newborn's SSN to the states for the
establishment of the state databases. HIPAA mandated that every patient,
employer, provider, and health plan be given a unique health identifier
number; that standards for electronic transmission be enacted; and that
national code sets for collection of individually identifiable medical
information be established. The bill allows the HHS Secretary to
establish her own privacy guidelines for federally-funded medical
databases-including the state vaccination databases-if Congress does not
enact their own privacy standards before August 1999. To date, HHS
recommendations have opposed parental consent requirements for release of
medical information when they define the situation to "be in the interest
of public health." Amendments that HHS endorses to protect privacy for
implementation of HIPAA registry proposals have all included this
imprecise, intentionally open-ended exception to consent. Early in 1993,
HHS Secretary Donna Shalala represented the administration's position
unequivocally: "This is an attempt to immunize every preschool child, not
just poor children". This is in spite of the fact that the U.S. has
already achieved a 98 percent vaccination rate for children entering
kindergarten, before any massive government-operated vaccine tracking
registry.

Evidence Of Abuse
Numerous abuses happening now on the state and local levels are just a
preview of what's likely to occur with a national tracking and
enforcement system. Children who are not part of the immunization
registries are being denied health insurance coverage, and enrollment in
public and private daycare, elementary schools, and colleges; parents
have been denied public assistance benefits. Some parents that have not
participated in the registries, or who veered from following the standard
vaccination schedule have been charged with neglect, abuse, or
endangerment, and have had their children seized merely on the word of
health officials, even before any finding of fact in a court. State child
welfare agencies have often assisted a vindictive former spouse to bring
charges against a parent who decides-no matter how judiciously-that one
or more vaccines are unsafe or unnecessary. In addition, not all states
allow for religious exemptions for parents to use if they have doubts
about privacy, or the safety of any of the vaccines on their child.

The National Immunization Program's (NIP) aggressive outreach activities,
dubbed "Reminder/Recall methods," have harassed and punished parents and
health-care providers who do not comply with the government requirements.
These activities would include mailings, phone calls and home visits that
could lead to on-the-spot vaccinations. The NIP's goals to "gather
wide-ranging information", and "to identify and target interventions in
every pocket of need", may be a clue why they want information on
extended adult family members included in the database.

To defer issues of vaccine safety and effectiveness, health officials
have disseminated the myth of neglectful or ignorant parents. However,
non-compliance does not necessarily mean the parents are irresponsible.
It is more often to the contrary, as Barbara Loe Fisher, Co-Founder &
President of NVIC (the national parent and educational organization
leading the opposition to vaccination registries) had stated before the
National Vaccine Advisory Committee Immunization Registries Workgroup on
Privacy and Confidentiality on May 14, 1998: "Educated health care
consumers instinctively know that a one-size-fits-all, narrow-minded
approach to disease control is dangerous when genetic variability and
unique environmental factors can put some children more at risk for
vaccine-induced injury and death than other children, and yet almost no
child is screened out of the mass vaccination program."

This article has summarized various tracking databases that will soon be
compiling profiles on U.S. citizens. But vaccination registries that have
been in place for at least a year in many states demonstrates that
government officials cannot be trusted with private medical information.
The recent example of Texas Health Dept. officials that were caught
building a vaccination database by "mining" birth certificate records and
Social Security applications before it was legal to do so, should be a
warning to the more trusting among us.

In the next issue, WB will survey the various state vaccination
registries and tracking systems and detail some of the violations to
privacy, medical, and parental rights. However, commenting on the abuses
happening now on the state level, Agneta Breitenstein, director of the
Health Law Institute in Boston, said: "There are three things that are
always true when registries are created: One, there will always be more
information collected than is needed to complete the task; two, it will
always be kept longer than we are told; and, three, it will always be
used for purposes other than intended."

Threats On The Horizon
With the establishment of state databases, the health care establishment
has the necessary framework to initiate the National Immunization
Registry Plan, which is being developed now by National Vaccine Advisory
Committee (NVAC) and the CDC's National Immunization Program (NIP). The
intent of this registry effort is to integrate all of the state databases
into one central (i.e. federal) tracking system controlled by the CDC and
HHS. This new system will track every child, using information gathered
from both public and private health systems. In the face of opposition by
civil liberties and parent groups, NIP has openly and consistently
favored mandatory inclusion of all children in the registry system
without consent of the parents, and to include personal family data that
goes far beyond medical and vaccination status, and with few limits on
its dissemination. NIP's position on privacy is clear: "State laws
intended to ensure privacy have presented barriers to immunization
registries in some areas. Preemptive Federal legislation is needed." As
one recent CDC publication stated: "CDC supports the ultimate goal of
enrollment of all U.S. preschool children in a state or community
immunization registry." NVAC's position is identical to NIP's in all
major respects.

Congress is also considering legislation that would implement a federally
operated immunization database to tag, track down and force adults to
comply with federal vaccination policies. People in professions like
health care, education, or law enforcement are likely to be the most
vulnerable to vaccination mandates enforced with this system. But it will
expand to people working in the food industry, and other service-related
professions. It will be accomplished through the assignment of a "unique
personal identifier", as outlined in the UPI regulations described
earlier. UPI had not been repealed last year, but merely defunded for
1999.

Going beyond just vaccinations, most registry advocates hope that
"immunization registries can contribute toward what could ultimately be
more comprehensive clinical and preventive data bases." (Immunization
News, Pennsylvania Forum for Primary Health Care, Vol.2, Issue 2, Summer
1997). In other words, immunization registries can become the
cornerstones for complete government patient databases. Today,
immunizations. Tomorrow, diagnoses and prescribed medications. Next year,
psychiatric or marital counseling records.

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Special thanks to Dawn Richardson, heading the opposition to the
vaccination registry in Texas, whose research provided the bulk of this
article.

Dawn Richardson, Co-founder, PROVE,
Parents Requesting Open Vaccine Education, <prove@swbell.net> (email),
(512) 918-8760. Her "Sunset" testimony is located at
<http://home.swbell.net/prove/txregistry/sunset.htm>, and her statement
to the CDC's NIP program against a proposed National Immunization
Registry may be found at
<http://home.swbell.net/prove/nationalregistry/nationalstatement.htm>